Contestant Information  (Please turn in with payment)

Name: _____________________________Age: ___  DOB: ____Age Division _______

Parents/Guardian: _______________________________________________________

Address: _______________________________________________________________

Phone: (_____)____________________ Other Contact:(____)___________________

Color Hair: ________________Eyes:________________Pets: _____________________

Favorite Color: ___________________Favorite Food: __________________________

Hobbies: ________________________________________________________________

There will be a $25 charge for all Returned Checks.  By signing below I agree that the pageant director, committee, and the facility is not responsible for any lost or stolen items, or responsible for any accident that occurs at, on the way to, or on the way from the above activity.  I agree to act in a civilized manner and agree that the contestant above may be disqualified at any time before, during, or after the pageant for ANY unruly, unsportsmanlike, or unbecoming conduct by the contestant, parent, and anyone accompanying the contestant, without a refund.